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结直肠癌筛查在乳腺癌、宫颈癌、前列腺癌、皮肤癌和肺癌幸存者中的应用。

Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors.

机构信息

Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.

Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.

出版信息

J Cancer Surviv. 2024 Apr;18(2):541-552. doi: 10.1007/s11764-022-01258-0. Epub 2022 Oct 10.

Abstract

PURPOSE

To examine whether sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions were associated with colorectal cancer (CRC) screening utilization among breast, cervical, prostate, skin, and lung cancer survivors.

METHODS

We analyzed the 2020 Behavioral Risk Factor Surveillance System (BRFSS) data on 9780 eligible cancer survivors. Descriptive statistics and multivariable logistic regression models were applied to assess the association between guideline-concordant CRC screening and the mentioned characteristics.

RESULTS

Overall, 81.9%, 65%, 88%,78.1%, and 80.1% of breast, cervical, prostate, skin, and lung cancer survivors received CRC screening, respectively (p-value < 0.001). In multivariable analysis, breast, cervical, and skin cancer survivors aged 60 years or older were associated with higher odds of receiving CRC screening. Respondents that had their recency of routine checkup two or more years before had lower odds of having CRC screening among cervical (OR = 0.06; 95% CI, 0.02-0.22), prostate (OR = 0.26; 95% CI, 0.14-0.49), and skin cancer (OR = 0.50; 95% CI, 0.36-0.70) survivors. The presence of chronic diseases was also associated with guideline-concordant CRC screening among breast, prostate, and skin cancer survivors.

CONCLUSIONS

Our findings provide important evidence on potential factors that are associated with guideline-concordant CRC screening utilization across different cancer survivors, which include older age, recency of routine checkup, and multiple chronic diseases. Moreover, variation in CRC screening utilization across cancer survivors may highlight missed opportunities for secondary cancer prevention.

IMPLICATIONS FOR CANCER SURVIVORS

Establishing clear CRC screening guidelines and including patient-provider communication on recommendation in cancer survivorship care may increase adherence to CRC screening.

摘要

目的

探讨社会人口统计学特征、医疗服务可及性、风险行为因素和慢性健康状况是否与乳腺癌、宫颈癌、前列腺癌、皮肤癌和肺癌幸存者的结直肠癌(CRC)筛查利用有关。

方法

我们分析了 2020 年行为风险因素监测系统(BRFSS)关于 9780 名合格癌症幸存者的数据。应用描述性统计和多变量逻辑回归模型评估了指南一致的 CRC 筛查与上述特征之间的关联。

结果

总体而言,乳腺癌、宫颈癌、前列腺癌、皮肤癌和肺癌幸存者接受 CRC 筛查的比例分别为 81.9%、65%、88%、78.1%和 80.1%(p 值均<0.001)。在多变量分析中,年龄在 60 岁或以上的乳腺癌、宫颈癌和皮肤癌幸存者接受 CRC 筛查的可能性更高。最近一次常规检查在两年或以上前的受访者,宫颈癌(OR=0.06;95%CI,0.02-0.22)、前列腺癌(OR=0.26;95%CI,0.14-0.49)和皮肤癌(OR=0.50;95%CI,0.36-0.70)幸存者进行 CRC 筛查的可能性较低。慢性疾病的存在也与乳腺癌、前列腺癌和皮肤癌幸存者的指南一致的 CRC 筛查有关。

结论

我们的研究结果提供了重要证据,证明了与不同癌症幸存者中指南一致的 CRC 筛查利用相关的潜在因素,包括年龄较大、最近常规检查时间以及多种慢性疾病。此外,癌症幸存者之间 CRC 筛查利用的差异可能突出了二级癌症预防的机会缺失。

对癌症幸存者的意义

制定明确的 CRC 筛查指南,并在癌症幸存者护理中纳入关于建议的医患沟通,可能会增加对 CRC 筛查的依从性。

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